Dr Michael Apple explains what GPs can do to help patients quit smoking, hopefully for good.

Dr Michael Apple explains what GPs can do to help patients quit smoking for good.

"GPs are generally delighted to help people who have decided to quit smoking. That's because about 40% of smokers will die from a smoking-related condition, so we know that stopping is one change that will make a big difference to your life", says Dr Apple.

People who stop smoking will see health benefits within days, such as improved taste and smell, while important benefits, such as lower risks of heart attack, stroke, lung cancer and improvements in breathing will happen in the first year or two.

"We've probably been chasing you to stop smoking if you have high blood pressure, diabetes, circulation problems or history of stroke, heart attack, angina, asthma or chronic lung disorders", says Dr Apple.

"My patients are often surprised to be asked about smoking when they see me about a painful knee, but many GPs have computer consultation programmes reminding us to ask about smoking habits."

Why should you quit smoking?

"I may ask you why you want to quit now. Sometimes it’s symptoms such as a persistent cough or coughing up blood. Sometimes it’s because a relative has developed a smoking-related illness, such as lung cancer.

"For women, it's sometimes because they're thinking about pregnancy.

"When people are about to quit smoking, it's important to check their blood pressure and weight, and to reassure them that, on average, weight gain after quitting is just a few pounds."

Dr Apple says he likes to know which stop smoking products his patients have already tried, as it helps him choose what to suggest next.

"I'll then tell you about other products, such as nicotine replacement products like chewing gum and skin patches, and prescription medicines that can help you stop smoking, and then go into their pros and cons."

Dr Apple says that he agrees a timescale for quitting, as there is evidence that this improves the chances of success. He then asks quitters to come into the surgery for a review. "I encourage people to try to quit with a friend or relative. I also point out the financial benefits of quitting, which can be thousands of pounds a year."

Stop Smoking Services

"There are excellent local NHS Stop Smoking Services. I'll give out details of these, especially to people who have tried several methods and who appreciate getting advice whenever they need it.

"These NHS services are very good at tailoring treatment to your lifestyle habits. With medication and the support of these services, you're four times more likely to give up successfully."

"Occasionally, I will prescribe bupropion (Zyban) – a drug that reduces the craving for nicotine. This isn't for everyone, as it can cause epileptic fits in people prone to them. It can also affect liver and blood pressure, so it needs close monitoring. But some people do very well with the medication, so it's worth considering.

"There's also a prescription drug known as varenicline (Champix) which blocks the effect of nicotine on the brain.

"All GPs realise that people try and fail in quitting smoking, just as they do in diet, exercise and other worthwhile lifestyle changes. It's part of our job to understand that and to sympathise, while gently encouraging you to try again."